Voriconazole and posaconazole need routine levels; most other antifungals do not, a review concludes

The edition in brief

A Therapeutic Drug Monitoring review concludes that routine monitoring is well supported for voriconazole and posaconazole, whose trough targets are linked to outcomes; isavuconazole monitoring may help in critically ill, paediatric and obese patients and those on extracorporeal therapy; echinocandins and amphotericin B are not routinely monitored. A case report measured long-acting cabotegravir and rilpivirine levels in a man given rifampicin for seven days with oral bridging: cabotegravir fell 57% and rilpivirine 83%, below target, and both recovered within a week of stopping, with viral load undetectable throughout. In healthy volunteers, enavogliflozin with glimepiride and metformin showed no clinically meaningful pharmacokinetic interaction, though glimepiride exposure rose 23% and glucose lowering was additive. Of 2,473 breastfeeding medication queries to the Lyon pharmacovigilance centre, 87% were answered in favour of continuing breastfeeding. FDA lists a Class II sterility recall of compounded tirzepatide syringes.